Contraception care is recognized as a basic human right, however, many individuals continue to face challenges in accessing adequate care. For youth, factors that influence access to prescription contraception include affordability, availability, acceptability, and youth awareness of these options. As a result, contraception uptake in Canada remains low, with 22.9 www.askusproject.ca ) and youth informed the chosen wording, colour scheme, images, and more. Our purposeful steps to involve embedded youth research assistants, acknowledge the differences and redistribution of power among researchers and youth advisors, use technology to promote collaboration and confidentiality and emphasize reciprocal knowledge sharing led to a meaningful co-design experience for us as youth research assistants. We argue that deeper considerations of accountability by academic researchers and embedded youth research assistants can further promote youth participation by enabling spaces where youth feel safe. Many youth face challenges in accessing contraception care. Factors such as affordability, availability, acceptability, and youth awareness of contraceptive options may create barriers for youth to access contraception. This has resulted in a low uptake of contraception among Canadian youth. Collaborating with youth to understand their experiences accessing contraception can help us develop solutions and services that yield stronger usability among youth. We invited youth advisors to participate in a co-design activity to generate research recruitment materials for a qualitative study called ‘Ask Us: Youth Voices to Improve Contraception Access’. This article was written from the perspective of four youth research assistants who also participated in the youth engagement activities before participant recruitment for this study. Through a series of virtual workshops, the youth advisors and youth research assistants developed research recruitment materials. We, the youth research assistants, reflected on the strategies used to encourage youth participation and identified the following themes: (i) Re-distribution of Power to Enable Youth Participation, (ii) Use of Technology to Promote Collaboration and Confidentiality and (iii) Emphasizing Reciprocal Knowledge Building. Following the co-design sessions, we created Ask Us study recruitment materials ( www.askusproject.ca ). Components of the recruitment materials, such as wording, colour scheme, images etc. were informed by the youth. We took steps to involve embedded youth researchers, acknowledge the differences and redistribution of power among researchers and youth advisors, use technology to promote collaboration and confidentiality and emphasize reciprocal knowledge sharing. Based on our insights as youth research assistants participating in this process, we conclude that the engagement activities led to a meaningful co-design experience for youth research assistants. In addition to these strategies, we encourage researchers to consider how they can remain accountable in creating co-design environments where youth feel safe.

Immigrant adolescents in Canada face challenges accessing accurate sexual and reproductive health (SRH) information and services. Many challenges stem from taboos associated with SRH, cultural and religious restrictions, and social beliefs regarding the unnecessity of SRH education for adolescents. We explored the SRH experiences of immigrant adolescents in the context of their cultural and religious perspectives. We engaged adolescents as collaborators and active participants in the research process. With the support of an Adolescent Advisory Group (AAG) and community partners, we conducted qualitative interviews with immigrant adolescents in Edmonton, Toronto, and Vancouver (n = 58). Through thematic analysis, we identified three broad themes: (1) 'What's really happening?' Experiencing body changes from puberty to adulthood; (2) 'It's something that's shameful': Encountering myths, misperceptions, and norms about SRH; and (3) 'I'll be there for you': Navigating family and digital resources for support. Our findings highlight the specific SRH challenges faced by immigrant adolescents in Canada, such as differences between cultural values, and communication barriers within families. Dealing with SRH matters is dependent on education, family readiness, and personal values attached to these topics. Programmes must focus on engaging cultural and religious preferences and tailoring interventions to adolescents' needs.

To summarize the literature describing Indigenous clients’ experiences accessing contraception and abortion services in Canada, and identify opportunities for health service improvement.

Background Pelvic cancers are among the most common cancers, impacting millions of individuals worldwide annually. However, little is known about the impact of more rare pelvic cancers on the sexual health of females.Aim In this study we explored sexual health experiences of female pelvic cancer survivors (FPCS) and their healthcare providers (HCP) in order to identify the most salient impacts of pelvic cancer on sexual function.Methods In this qualitative study, semi-structured online interviews were conducted with 15 female patients with vulvar, vaginal, uterine, ovarian, endometrial, cervical, bladder, and/or colorectal cancers. Additionally, semi-structured online interviews were conducted with HCPs who treat pelvic cancers (n = 9). For data analysis, qualitative framework analysis was used.Outcomes We used the collected data and analysis of findings to establish recommendations including ways to improve sexual health and function in female survivors of pelvic cancer.Results Most FPCS experienced negative impacts on their sexual health and function through increased pain and dryness, bleeding due to atrophy, decreased libido, and psychosocial issues such as body dysmorphia. Females with the rarer vulvar and vaginal cancers faced additional challenges to their sexual health such as shortening of vaginal canals, high levels of neuropathy, lack of sexual activity with their partners, and suicidal ideation. FPCS had unmet sexual health needs, which can be attributed to lack of appropriate training by HCPs and lack of resources and availability of services. Although HCPs recognized the importance of providing sexual healthcare, they lacked confidence in their ability to facilitate a conversation on sexual health with their patients, and often avoided this topic.Clinical implications The sexual health outcomes of FPCS can be improved by providing targeted training for HCPs, developing standard resources for sexual health, and integrating tiers of support, including group interventions and counseling.Strengths and limitations The main strength of this study is that data were collected from HCPs as well as FPCS, thus providing a more in-depth overall picture of the current strengths and weaknesses of the resources for sexual health support available for this patient population. A limitation of this study is that the experiences of transgender men were not captured.Conclusions Sexual difficulties are very common in all FPCS, particularly survivors of vulvar and vaginal cancers. Improvement of sexual health outcomes is needed in this patient population, which can be achieved by providing more training for HCPs, developing robust resources for FPCS and their sexual health, and providing more opportunities for tiered support.

Introduction There is little to no evidence in Canada on the barriers that youth face when accessing contraception. We seek to identify the contraception access, experiences, beliefs, attitudes, knowledge, and needs of youth in Canada, from the perspectives of youth and youth service providers. Methods and analysis This prospective, mixed-methods, integrated knowledge mobilisation study, the Ask Us project, will involve a national sample of youth, healthcare and social service providers, and policy makers recruited via a novel relational mapping and outreach approach led by youth. Phase I will centre the voices of youth and their service providers through in-depth one-on-one interviews. We will explore the factors influencing youth access to contraception, theoretically guided by Levesque’s Access to Care framework. Phase II will focus on the cocreation and evaluation of knowledge translation products (youth stories) with youth, service providers, and policy makers. Ethics and dissemination Ethical approval was received from the University of British Columbia’s Research Ethics Board (H21-01091). Full open-access publication of the work will be sought in an international peer-reviewed journal. Findings will be disseminated to youth and service providers through social media, newsletters, and communities of practice, and to policy makers through invited evidence briefs and face-to-face presentations.

As young women transition from adolescence to adulthood, they begin to explore their sexual identities and sexual relationships. The current literature supports the relationship between sexual quality of life (QOL) and mental well-being. However, this relationship has not yet been replicated in undergraduate women. In order to address this gap, the authors assessed the correlation between sexual QOL and mental well-being among a sample of women undergraduate students in Canada. The study design was cross-sectional in nature, and demographic information was collected, along with the completion of validated measures of sexual QOL and mental well-being. A total of 157 individuals participated. After removing those who did not meet inclusion criteria and those with > 90% incomplete responses, 124 valid survey responses remained for analysis. A hierarchical multivariable linear regression was conducted while controlling for age, sexual orientation, exercise, history of nonconsensual sexual contact, household income, and self-perceived health status. Every one-unit increase in sexual QOL was associated with a 0.35 increase in mental well-being (95% CI 0.105–0.428, p = .002). A history of unwanted or nonconsensual sexual activity had a significant negative correlation with mental well-being ( p = .027). The authors’ findings suggest a significant relationship between sexual QOL and mental well-being. There is a strong opportunity for universities to bolster the support services available to students, with a required focus on women with a history of nonconsensual sexual contact.